The New Obamacare Economy

The employees of Hope Haven, a nonprofit organization in Burlington, Iowa, provide services to some five hundred people with intellectual and physical disabilities, often in their clients’ homes. Depending on the day, they can be called upon to work as companions, cleaners, readers, personal shoppers, cooks, or bathers. “We have situations where we support people twenty-four hours a day,” Bob Bartles, Hope Haven’s executive director, told me. His staff members perform intimate labors of compassion, yet, as low-wage workers, they, too, are a vulnerable class. “Our entry wage is $11.25 per hour,” Bartles said. “We’re about ninety-per-cent funded by the government. Most of that is Medicaid, and Medicaid doesn’t set rates that allow us to pay much more.”